Sport climbing is associated with unique upper- and lower-limb injuries involving predominantly the hand, elbow, and shoulder, and to a lesser extent the foot. Many pathologic conditions are limited to sport climbing. Physicians treating sport climbers should be aware of these unique injuries and overuse syndromes. This article presents an overview of orthopedic problems (injuries, overuse syndromes, and fractures) resulting from sport climbing. Sport climbing is defined in the context of existing mountain sports, and its characteristics and technical terms are presented. The etiology, diagnosis, and specific treatment for orthopedic problems associated with sport climbing are described.